Efficacy and Safety of Clomiphene Citrate for Late-Onset Hypogonadism as Evaluated by Aging Male Symptom Rating Scale Over One Year.

OBJECTIVE

To evaluate the efficacy and safety of clomiphene citrate for late-onset hypogonadism by assessing changes in serum testosterone levels and Aging Males Symptoms scores over 1 year.

MATERIALS AND

METHODS

This retrospective study comprised 54 men (44.2 ± 0.9 years old) with hypogonadal symptoms. Clomiphene citrate was given as 50 mg tablets every other day for a maximum of 1 year. Blood test results and scores of the Aging Males Symptoms rating scale were basically obtained every 3 months. Factors defining elevated testosterone levels were analyzed among pretreatment endocrinological data and age. Adverse events were directly confirmed by the physicians.

RESULTS

Serum testosterone levels increased and remained high over 1 year. Similarly, the score of the Aging Males Symptoms rating scale appeared to decline over 1 year. However, the score regarding sexual dysfunction did not show significant improvement. Multiple regression analysis showed that luteinizing hormone was the only independent factor influencing testosterone elevation. No adverse events occurred in our patients.

CONCLUSIONS

This is the first study, to our knowledge, showing the efficacy of treatment with clomiphene citrate for late-onset hypogonadism based on the Aging Males Symptoms rating scale score. Because acceptable efficacy and no adverse events were found for 1 year, we emphasize that clomiphene citrate should be one alternative treatment for testosterone replacement in young patients desiring children or patients who are overly concerned about testicular atrophy, especially those with a low serum luteinizing hormone level.